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儿童出生后前6个月抗生素使用与体重的关联

Association of Antibiotic Use during the First 6 Months of Life with Body Mass of Children.

作者信息

Kwak Ji Hee, Lee Seung Won, Lee Jung Eun, Ha Eun Kyo, Baek Hey-Sung, Lee Eun, Kim Ju Hee, Han Man Yong

机构信息

Department of Pediatrics, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, Seoul 03181, Korea.

Department of Data Science, College of Software Convergence, Sejong University, Seoul 05006, Korea.

出版信息

Antibiotics (Basel). 2022 Apr 11;11(4):507. doi: 10.3390/antibiotics11040507.

Abstract

In this study, our objective was to assess the association of body mass in preschool children with the use of antibiotics within 6 months after birth. National administrative databases were used to examine all children born between 2008 and 2009 in Korea. Exposure was defined as the use of systemic antibiotics during the first 6 months of age. The observed outcomes were stunting (height for age [HFA] z score < −2.0), short stature (HFA z score < −1.64), overweight (body mass index [BMI] for age z score ≥ 1.04), and obesity (BMI for age z score ≥ 1.64), and the children’s height and body weight were measured from three to six years of age. To balance characteristics between the antibiotic user and non-user groups, propensity score matching was performed. The outcomes were evaluated using a generalized estimation equation with the logit link function. Analysis of antibiotic use by children during the first 6 months of life indicated there were 203,073 users (54.9%) and 166,505 non-users (45.1%). After PS matching, there were 72,983 antibiotic users and 72,983 non-users. Antibiotic use was significantly associated with stunting (aOR = 1.198, 95% CI = 1.056 to 1.360) and short stature (aOR = 1.043, 95% CI = 1.004 to 1.083), and had significant negative association with HFA z score (weighted β = −0.023). The use of an antibiotic for 14 days or more had a marked association with stunting. Antibiotic use was also associated with overweight, obesity, and increased BMI for age z score. Antibiotic use during the first 6 months of life increased the risk of stunting, short stature, overweight, and obesity in preschool children.

摘要

在本研究中,我们的目标是评估学龄前儿童的体重与出生后6个月内使用抗生素之间的关联。利用国家行政数据库对2008年至2009年在韩国出生的所有儿童进行了调查。暴露定义为在出生后头6个月内使用全身性抗生素。观察到的结果包括发育迟缓(年龄别身高[HFA]z评分<-2.0)、身材矮小(HFA z评分<-1.64)、超重(年龄别体重指数[BMI]z评分≥1.04)和肥胖(年龄别BMI z评分≥1.64),并在3至6岁时测量了儿童的身高和体重。为平衡抗生素使用者和非使用者组之间的特征,进行了倾向得分匹配。使用具有logit链接函数的广义估计方程对结果进行评估。对出生后头6个月内儿童使用抗生素情况的分析表明,有203,073名使用者(54.9%)和166,505名非使用者(45.1%)。倾向得分匹配后,有72,983名抗生素使用者和72,983名非使用者。抗生素使用与发育迟缓(调整后比值比[aOR]=1.198,95%置信区间[CI]=1.056至1.360)和身材矮小(aOR=1.043,95%CI=1.004至1.083)显著相关,并且与HFA z评分呈显著负相关(加权β=-0.023)。使用抗生素14天或更长时间与发育迟缓有明显关联。抗生素使用还与超重、肥胖以及年龄别BMI z评分增加有关。出生后头6个月内使用抗生素会增加学龄前儿童发育迟缓、身材矮小、超重和肥胖的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c92/9033100/8999fb46afcb/antibiotics-11-00507-g001.jpg

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